Background Tonsillectomy and adenotonsillectomy are among the most commonly performed procedures by Ear, Nose and Throat surgeons. In regional Australia, limited access to specialist services and large geographical distances can delay recognition and management of complications such as post-tonsillectomy bleeding (PTB), a potentially life-threatening event. As a result, ENT surgeons often advise patients to remain within close proximity to an ENT-equipped facility during the immediate post-operative period. Methods This prospective observational study evaluated adherence to post-operative proximity advice among patients undergoing tonsillectomy or adenotonsillectomy at a regional hospital in Queensland, Australia. Patients were classified as “local” (<45 minutes from hospital) or “distant” (>45 minutes). Adherence was assessed based on self-reported compliance with proximity advice during routine follow-up. Results Of 347 procedures performed during the study period, 148 involved patients residing >45 minutes from hospital. Among these, 97 (65.5%) had follow-up data available. Of those, 79 patients (81.4%, 95% CI 73.7-89.1%) self-reported adherence to the recommended recovery location advice. Conclusion While self-reported adherence to post-operative proximity advice was high among respondents, conclusions are confounded by those lost to follow-up. These findings highlight the need for improved follow-up engagement and targeted discharge planning to support safe recovery in geographically dispersed populations.